Scratching the surface of allergic transfusion reactions

Authors

  • William J. Savage,

    Corresponding author
    1. From the Division of Transfusion Medicine, the Division of Allergy and Clinical Immunology, and the Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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  • Aaron A.R. Tobian,

    1. From the Division of Transfusion Medicine, the Division of Allergy and Clinical Immunology, and the Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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  • Jessica H. Savage,

    1. From the Division of Transfusion Medicine, the Division of Allergy and Clinical Immunology, and the Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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  • Robert A. Wood,

    1. From the Division of Transfusion Medicine, the Division of Allergy and Clinical Immunology, and the Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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  • John T. Schroeder,

    1. From the Division of Transfusion Medicine, the Division of Allergy and Clinical Immunology, and the Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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  • Paul M. Ness

    1. From the Division of Transfusion Medicine, the Division of Allergy and Clinical Immunology, and the Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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  • Presented in part at the Annual Meeting, AABB, 2011, Emily Cooley Memorial Lecture. Supported in part by ASH Scholar Award, R21HL107828.

William J. Savage, Blood Bank, 75 Francis St., Amory 260, Boston, MA 02115; e-mail: wjsavage@partners.org.

Abstract

Allergic transfusion reactions (ATRs) are a spectrum of hypersensitivity reactions that are the most common adverse reaction to platelets and plasma, occurring in up to 2% of transfusions. Despite the ubiquity of these reactions, little is known about their mechanism. In a small subset of severe reactions, specific antibody has been implicated as causal, although this mechanism does not explain all ATRs. Evidence suggests that donor, product, and recipient factors are involved, and it is possible that many ATRs are multifactorial. Further understanding of the mechanisms of ATRs is necessary so that rationally designed and cost-effective prevention measures can be developed.

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